| NPI | 1164531430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A42740) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A42740) |
| 207W00000X Ophthalmology (Licence: NV 6973) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-04-03 |